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Research updates

The MS Trust runs a regular search for interesting and relevant research articles relating to multiple sclerosis using Medline, a specialised search engine for medical journals. The original abstracts to each of the articles can be accessed via the links provided.

For further information on any topic please contact the information team at info@mstrust.org.uk.

Recent highlighted research...

Summary

In this Italian study, 139 participants with MS were allocated to either an online mindfulness-based meditation course or an educational course combined with exercise.

At the end of the eight week course, those receiving the online training in meditation had greater improvement in quality of life and reduction in depression, anxiety, and sleep problems. However, six months later, measures for the two groups were no longer different, with both groups returning to pre-treatment levels.

Researchers conclude that mindfulness-based meditation requires practice to maintain benefits. They recommend that future studies should test ways to encourage people to practice at home so that the positive effects of meditation can be maintained in the longer term.

Background

The psychological and social consequences of living with MS can have a significant effect on what is known as health-related quality of life, or a sense of well-being. This in turn can result in an increased impact of MS symptoms such as pain and fatigue, leading to further negative effects on mood and your social life … and so on. This study investigated meditation as a means to encourage mindfulness in an effort to break this cycle.

How this study was carried out

Italian researchers allocated 139 people with MS to receive an online meditation course or an educational course combined with exercise.

The meditation intervention consisted of eight weeks of an online mindfulness-based stress reduction course which the researchers had developed themselves. The course included music meditations, discussions about symptom acceptance, videoconferences with a qualified mindfulness trainer, and live sessions conducted through Skype video-chat. The educational intervention group took an online course consisting of eight weeks of informational videos and home exercises. The average size of groups was five participants.

The main measure of the study was quality of life, and secondary measures included anxiety, depression, sleep measurements, and fatigue. These outcomes were measured after eight weeks, and after six months.

What was found

The meditation course group reported higher quality of life and lower depression, anxiety, and sleep problems at the end of eight week course, compared to the education course group. However, after six months, measures for the two groups were no longer significantly different, with both groups returning to pre-treatment levels.

Dropout rates were similar in the two groups, with discontinuation largely due to lack of available time, either due to work or family commitments.

Fatigue was not significantly reduced by either treatment both at the end of the courses or six months later.

Trainers reported technical problems such as slow internet connections for most sessions although this was not considered to be a major issue.

What does it mean?

This study showed that an online meditation course can be an effective treatment to improve psychological well-being in the short term.

Previous studies have also shown benefits of mindfulness-based therapies for people with MS but the design of these studies has been criticised, making it difficult to draw definitive conclusions. In this study, the researchers aimed to carry out a more rigorous evaluation by using a comparison group that was also receiving an active treatment, rather than just basic medical care, and by carrying out a six month follow-up to see whether changes were maintained.

The authors comment on the fact that improvements in well-being were not maintained over time, noting that mindfulness-based stress reduction requires practice to obtain positive results. They suggest that future studies should test ways to encourage people to practice at home so that the positive effects of meditation can be maintained after the course ends.

A potential barrier for taking part in mindfulness based interventions is the time commitment and the need to travel to a weekly group meeting. The researchers chose to develop and evaluate an online course to make it easier for people to take part.

More about mindfulness and meditation

Mindfulness is a type of psychological therapy that can be used to manage some of the symptoms of MS. It involves learning to bring our full attention to our experience moment by moment in a kind and non-judgemental way so that we can be aware of what is really happening in our bodies, our minds and emotions and our environment.

Meditation is one of the techniques you can use to improve mindfulness. Mindfulness meditation involves sitting silently and paying attention to thoughts, sounds, and the sensations of breathing or parts of the body, bringing your attention back whenever the mind starts to wander.

Yoga and tai-chi can also help with developing awareness of your breathing and encourage mindfulness.

Rae-Grant A, Day GS, Marrie RA, et al.Comprehensive systematic review summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.
Neurology. 2018 Apr 24;90(17):789-800.abstractRead the full text of this paper

Rae-Grant A, Day GS, Marrie RA, et al.Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.
Neurology. 2018 Apr 24;90(17):777-788.abstractRead the full text of this paper

Psychological aspects

Barker AB, Lincoln NB, Hunt N, et al.Social identity in people with multiple sclerosis: an examination of family identity and mood.
Int J MS Care. 2018 Mar-Apr;20(2):85-91.abstractRead the full text of this paper

Phyo AZZ, Demaneuf T, De Livera AM, et al.The efficacy of psychological interventions for managing fatigue in people with multiple sclerosis: a systematic review and meta-analysis.
Front Neurol. 2018 Apr 4;9:149.abstractRead the full text of this paper